Repurposing potential of ketamine: Opportunities and challenges
C S Gautam, Sonia S Mahajan, Jatin Sharma, Harmanjit Singh, Jagjit Singh
Indian Journal of Psychological Medicine January 17, 2020 Peer reviewed DOI: 10.4103/ijpsym.ijpsym_228_19 via DOAJ
Summary
Esketamine, a potent form of ketamine, is approved for treatment-resistant depression but raises safety concerns due to its psychedelic effects and potential for abuse. While ketamine was originally an anesthetic, it is being explored for various conditions, including anxiety and chronic pain. Ongoing trials are investigating its repurposing for these uses, but the long-term safety of esketamine remains in question.
Study at a glance
| Design | review |
|---|---|
| Key finding | Esketamine has been approved for treatment-resistant depression, but its long-term safety is concerning due to potential abuse and psychedelic effects. |
Abstract
Ketamine is a noncompetitive antagonist of the N-methyl-D-aspartate (NMDA) receptor which also interacts with various other receptors that account for its myriad actions. Originally approved as a general anesthetic, it is being explored to be repurposed for numerous other indications such as depressive disorders, suicidal ideation, substance-use disorders, anxiety disorders, chronic pain, refractory status epilepticus, and bronchial asthma exacerbations. Numerous trials are ongoing for the same. The nasal spray of esketamine, a more potent S (+) enantiomer of ketamine, has been approved by the United States Food and Drug Administration (USFDA) for treatment-resistant depression along with the oral antidepressants. However, there are concerns about its safety on long term use, given its psychedelic effects and potential abuse. In this review, we discuss repurposing ketamine for potential therapeutic use and about the safety concerns related to ketamine and esketamine.